Chronicles of a Student-Doctor #1

  
CHAPTER 1: PEDIATRIC POSTING

  
Welcome to Pediatric Ward.

      

A ward of crying babies and wailing toddlers.

There you find concerned Mothers and sometimes, Fathers (or other care-givers) seated all-night nursing their sick children back to health. 

I could imagine some of them counting the days, hours, minutes and perhaps seconds, until the Doctors declare them free to take their children/wards home. 

Having a sick child is worrisome enough, but having to stay in the hospital for a couple of days or weeks, is nothing but a nightmare.
On my first day, I presented to the Neonatal unit/Newborn Nursery (attached to the Maternity ward). I saw lots of day-old babies in the Nursery, undergoing a form of newborn screening. 

 

A Neonatal Unit (Photo-credit: WEB)
 
The scenario painted appeared to be both cute and cruel. Babies whimpering at the prick of needles; wondering in their little minds why they had been separated from the warmth and comfort of their mothers’ breasts. There and then I learnt how to put on a clean latex glove, and allow a crying baby to suck on my finger in order to be temporarily pacified.
Nothing beats the innocence of new life, cuddly little beings in all their dependence and vulnerability; bringing smiles to the faces and hearts of their loved ones. Never mind the fact that the adventure is just about to begin, from the basic challenges of constantly nursing, and changing soiled diapers, to the hospital visits for well-child exams and all the routine immunizations that must be completed. Then the financial, physical, spiritual, social and psychological implications of parenting a child; and providing basic needs like food, shelter, security, education and the rest. My submission is that child-rearing is a full-time job and future parents should carefully consider that before applying.
The purpose of the newborn screening is to rule out any infection that might have been transmitted in-utero or during delivery from the mother to the baby, and other potentially fatal metabolic disorders not apparent at birth. The detection of pathologic Jaundice is considered a priority (especially in premies), to prevent the sequela of kernicterus. Fortunately, most of the babies I saw did well and were soon discharged home with their mothers.
The Neonatal unit was also responsible for receiving babies born via caesarean sections. I got to see newly delivered babies assessed at the resuscitation bay, and they were afterwards transferred to the Nursery or the NICU as the case demanded.
After sometime, I was taken to the main Pediatric ward. The Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU) were also attached to it. The Pediatric ward is the most beautiful ward in the medical facility I’m currently at. It is comparatively large, accommodating, colorful and very child-friendly. 

  

Sick kids and their care-givers have the opportunity to walk into an adjacent courtyard to enjoy the scenery of the outdoors. Often times, children who are healthy enough to play, are seen running about or entertaining each other with all sorts of games. I always find it a heart-warming scenario. 
Each day on the ward began with a pre-round with the medical intern and registrar, followed by the general round with the consultant. After the rounds, the consultant would usually have teaching sessions with the medical students. Sometimes we are given topics to present and we ask our Preceptor questions as needed. After that, we go back to the ward to clerk patients or to assist the medical intern in carrying out the tasks for the day.

On the ward, I had the opportunity to talk to parents or guardians of a number of patients, and I learnt that to get maximal information, I had to ask the right kind of questions. Everything mattered from whether the child was born prematurely or at term, to the living conditions in the home, education of the child, and the kind of food the child ate. I also learnt the basics of the physical examination and assessment of the general wellbeing of a child.

During my first week, due to the lengthy Ward rounds, I thought I would collapse because my feet were sore. As the days passed however, I developed enough stamina. I guess I caught the flu too at the earlier part of my posting, but thankfully it soon passed.

  
 
(Random-selfie: With my sweetheart, Asholly. She blogs here).
Most of the cases I saw were relatively benign conditions, like: upper respiratory tract infections, Asthma, Sickle cell disease, Pneumonia, Diabetic Mellitus, Seizures, Urinary Tract Infections and Gastroenteritis. We also had some unusual cases like Chronic renal disease, Failure to thrive, Malnutrition among others.
One major highlight of my pediatric posting was the story I wrote about this little girl in: A LESSON FROM THE WARD.
Thankfully, many of the patients I saw during that period got well and were discharged home as appropriate. Sadly, we lost a few patients too. I remember one young teen in particular that died of some sort of cancer. It was a very emotional experience because I interacted with him in person, and I still have vivid memories about it till date.
At our weekly outpatient clinics, we did lots of well-child exams for children who were born prematurely. It was always interesting to hear mothers gladly talk about their kids’ developmental milestones.

 

During the posting, I also had the opportunity to attend a sickle-cell symposium funded by the Centre for Global Health, Medical University of South Carolina organized in conjunction with The SVG sickle cell Association. And it was quite an enlightening experience.

Finally, I had one of the best Consultants in M.C.M.H as my Preceptor- Dr. R. Boyle. A diligent, approachable and motherly figure. I really admired our cute and proper intern too, Dr. Joseph. 

The Pediatric Nurses and other staff were helpful as well. My colleagues were also nice and each of them contributed to making the posting a remarkable one.

Above all I’m thankful to God, for all I learnt and the experiences I had during that period.

In considering a specialty however, I don’t think Pediatrics would be one of my top choices. I honestly believe that whoever chooses to work with really young kids (5 years and under) as a healthcare provider or daycare attendant or classroom teacher must have a remarkable level of patience. I’ve had occasions to baby-sit before, and no matter how enjoyable it seems at first, it always turned out to be hardwork. 

Don’t get me wrong, babies and toddlers are fun to be with, but my level of tolerance with nonsensical tantrums is quite low. And more often than not, in dealing with kids I come off as being very strict. I’m always like “Sit down there” “Don’t touch that” and so on. With time, I was able to understand that most kids are just naturally playful and restless, and the calm ones (like I was, as confirmed by my parents…lol) are the exception. I think it’s still safe for me to conclude that I won’t cope as a Pediatrician. Ehm, as for Motherhood, I know I will enjoy the experience! 

(Photo-credit: WEB)

*** *** ***

Glossary
:


SVG
: Saint Vincent and the Grenadines.



In utero
: during Pregnancy.



Kernicterus
: Severe jaundice in a newborn with damage to the brain leading to cerebral palsy, mental retardation, vision problems or hearing loss.



Premies
: Babies born prematurely (i.e. less than 37 weeks).



Ward rounds
: a regular (often daily) visit to patients on admission to the hospital war by medical staff, for the purpose of assessing and making relevant decisions based on each patient’s health.

Thank you for reading!

:::requ1ne:::

Advertisements

2 thoughts on “Chronicles of a Student-Doctor #1

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s